PA-C: PHYSICIAN ASSISTANT-CERTIFIED EXAM | 100% VERIFIED
EXAM QUESTIONS AND CORRECT ANSWERS | LATEST 2026/2027
VERSION | PASS GUARANTEE
1. A 58-year-old man presents with crushing substernal chest pain radiating
to his left arm, diaphoresis, and nausea for the past 45 minutes. His ECG
shows ST-segment elevation in leads II, III, and aVF. Which coronary artery
is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
ANSWER : C
2. A 65-year-old woman with a history of hypertension presents with sudden
onset of tearing chest pain radiating to her back. BP is 180/100 mmHg in the
right arm and 160/90 mmHg in the left arm. The most appropriate next step
is:
A. Administer thrombolytics
B. Obtain a CT angiography of the chest
C. Perform emergent cardiac catheterization
D. Administer nitroglycerin and aspirin
ANSWER : B
3. Which of the following ECG findings is most consistent with Wolff-
Parkinson-White (WPW) syndrome?
, A. Prolonged PR interval and wide QRS complex
B. Short PR interval, delta wave, and wide QRS complex
C. Peaked P waves and right axis deviation
D. ST depression in lateral leads
ANSWER : B
4. A patient with heart failure is started on a new medication and returns 2
weeks later with a dry cough. Which medication is most likely responsible?
A. Carvedilol
B. Lisinopril
C. Spironolactone
D. Furosemide
ANSWER : B
5. Which of the following is the most common cause of right-sided heart
failure?
A. Tricuspid stenosis
B. Pulmonary embolism
C. Left-sided heart failure
D. Cor pulmonale
ANSWER : C
6. A 72-year-old man presents with syncope. His ECG shows complete heart
block (third-degree AV block). The most appropriate initial management is:
A. Oral digoxin
B. Immediate transcutaneous pacing
C. IV adenosine
D. Oral metoprolol
ANSWER : B
7. Which valve lesion produces a holosystolic murmur best heard at the
apex, radiating to the axilla?
, A. Aortic stenosis
B. Mitral valve prolapse
C. Mitral regurgitation
D. Tricuspid regurgitation
ANSWER : C
8. A 45-year-old patient with known hypertension is found to have a
potassium level of 2.8 mEq/L and metabolic alkalosis. Aldosterone level is
elevated and renin level is suppressed. The most likely diagnosis is:
A. Cushing syndrome
B. Primary hyperaldosteronism (Conn syndrome)
C. Renovascular hypertension
D. Pheochromocytoma
ANSWER : B
9. Which of the following medications is contraindicated in a patient with
acute decompensated heart failure and systolic dysfunction?
A. Furosemide
B. Nitroglycerin
C. Verapamil
D. Dobutamine
ANSWER : C
10. A patient presents with palpitations. ECG shows irregularly irregular
rhythm with absent P waves and fibrillatory baseline. Rate is 120 bpm. First-
line rate control agent for this patient with no structural heart disease is:
A. Amiodarone
B. Digoxin
C. Diltiazem
D. Procainamide
ANSWER : C
, 11. A 50-year-old smoker presents with exertional calf pain relieved by rest.
ABI (ankle-brachial index) is 0.6. This presentation is most consistent with:
A. Deep vein thrombosis
B. Peripheral arterial disease
C. Chronic venous insufficiency
D. Baker cyst
ANSWER : B
12. Which of the following is the most appropriate management for a stable
patient with symptomatic bradycardia (HR 40 bpm) not responding to
atropine?
A. IV amiodarone
B. IV epinephrine drip
C. Transcutaneous pacing
D. Oral metoprolol
ANSWER : C
13. An S3 gallop is most indicative of:
A. Left ventricular hypertrophy
B. Increased ventricular stiffness
C. Volume overload and decreased ventricular compliance
D. Pericardial effusion
ANSWER : C
14. Which of the following is a class I indication for coronary artery bypass
grafting (CABG)?
A. Single-vessel disease involving the LAD
B. Left main coronary artery stenosis >50%
C. Stable angina refractory to medical therapy
D. Non-ST-elevation MI in a stable patient
ANSWER : B
EXAM QUESTIONS AND CORRECT ANSWERS | LATEST 2026/2027
VERSION | PASS GUARANTEE
1. A 58-year-old man presents with crushing substernal chest pain radiating
to his left arm, diaphoresis, and nausea for the past 45 minutes. His ECG
shows ST-segment elevation in leads II, III, and aVF. Which coronary artery
is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
ANSWER : C
2. A 65-year-old woman with a history of hypertension presents with sudden
onset of tearing chest pain radiating to her back. BP is 180/100 mmHg in the
right arm and 160/90 mmHg in the left arm. The most appropriate next step
is:
A. Administer thrombolytics
B. Obtain a CT angiography of the chest
C. Perform emergent cardiac catheterization
D. Administer nitroglycerin and aspirin
ANSWER : B
3. Which of the following ECG findings is most consistent with Wolff-
Parkinson-White (WPW) syndrome?
, A. Prolonged PR interval and wide QRS complex
B. Short PR interval, delta wave, and wide QRS complex
C. Peaked P waves and right axis deviation
D. ST depression in lateral leads
ANSWER : B
4. A patient with heart failure is started on a new medication and returns 2
weeks later with a dry cough. Which medication is most likely responsible?
A. Carvedilol
B. Lisinopril
C. Spironolactone
D. Furosemide
ANSWER : B
5. Which of the following is the most common cause of right-sided heart
failure?
A. Tricuspid stenosis
B. Pulmonary embolism
C. Left-sided heart failure
D. Cor pulmonale
ANSWER : C
6. A 72-year-old man presents with syncope. His ECG shows complete heart
block (third-degree AV block). The most appropriate initial management is:
A. Oral digoxin
B. Immediate transcutaneous pacing
C. IV adenosine
D. Oral metoprolol
ANSWER : B
7. Which valve lesion produces a holosystolic murmur best heard at the
apex, radiating to the axilla?
, A. Aortic stenosis
B. Mitral valve prolapse
C. Mitral regurgitation
D. Tricuspid regurgitation
ANSWER : C
8. A 45-year-old patient with known hypertension is found to have a
potassium level of 2.8 mEq/L and metabolic alkalosis. Aldosterone level is
elevated and renin level is suppressed. The most likely diagnosis is:
A. Cushing syndrome
B. Primary hyperaldosteronism (Conn syndrome)
C. Renovascular hypertension
D. Pheochromocytoma
ANSWER : B
9. Which of the following medications is contraindicated in a patient with
acute decompensated heart failure and systolic dysfunction?
A. Furosemide
B. Nitroglycerin
C. Verapamil
D. Dobutamine
ANSWER : C
10. A patient presents with palpitations. ECG shows irregularly irregular
rhythm with absent P waves and fibrillatory baseline. Rate is 120 bpm. First-
line rate control agent for this patient with no structural heart disease is:
A. Amiodarone
B. Digoxin
C. Diltiazem
D. Procainamide
ANSWER : C
, 11. A 50-year-old smoker presents with exertional calf pain relieved by rest.
ABI (ankle-brachial index) is 0.6. This presentation is most consistent with:
A. Deep vein thrombosis
B. Peripheral arterial disease
C. Chronic venous insufficiency
D. Baker cyst
ANSWER : B
12. Which of the following is the most appropriate management for a stable
patient with symptomatic bradycardia (HR 40 bpm) not responding to
atropine?
A. IV amiodarone
B. IV epinephrine drip
C. Transcutaneous pacing
D. Oral metoprolol
ANSWER : C
13. An S3 gallop is most indicative of:
A. Left ventricular hypertrophy
B. Increased ventricular stiffness
C. Volume overload and decreased ventricular compliance
D. Pericardial effusion
ANSWER : C
14. Which of the following is a class I indication for coronary artery bypass
grafting (CABG)?
A. Single-vessel disease involving the LAD
B. Left main coronary artery stenosis >50%
C. Stable angina refractory to medical therapy
D. Non-ST-elevation MI in a stable patient
ANSWER : B
